| NPI | 1811250129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W HOWARD CFO 865-934-6708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: TN L000000011170) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2020-09-30 |